BRAVA® and Tissue Engineering*

Providing the Best in Natural Breast Reconstruction to Orlando & nearby areas of Florida

What is BRAVA®

The BRAVA® device consists of two plastic domes with a silicone edge seal that fit over the breasts. They are held in place by a custom made bra. Attached to the domes is a small electric suction pump that applies continuous suction to the breast skin and underlying tissues. This suction actually stretches and expands the breast skin and underlying tissues, analagous to expanding a sponge.


This process also increases the blood supply and flow to the tissues and allows much greater volume of fat to be grafted successfully and maintained. A similar concept is used successfully to apply suction to healing wounds to rapidly increase the rate of healing.

It is recommended that the BRAVA® be worn 8-10 hours a day for about 3 weeks before and 3 weeks after a fat grafting procedure. Most women apply the BRAVA® when they get home in the evening and sleep with the device.

The inconvenience of wearing BRAVA® is far outweighed by the improved fat grafting results obtained. For breast reconstruction the benefits are a completely natural reconstruction without any additional large incisions or scars, and far fewer complications than those associated with other reconstruction procedures.


For the breast augmentation patient, BRAVA® is strongly recommended to allow the maximum amount of fat grafting in a single procedure. 

For the breast reconstruction patient, BRAVA® is essential in the breast regeneration process to prepare the tissues for optimal fat grafting.

Preparing breast tissue with the BRAVA® device promotes satisfactory and long-lasting results from breast reconstruction and augmentation. Without the use of BRAVA®, most studies show that the most a breast can be enlarged with a single grafting procedure is about 150cc.

In the US, the average breast implant size is at least 300cc. Trying to introduce too much fat at one time is counterproductive as the fat is under too much pressure and will not survive. By using BRAVA® before the fat grafting procedure,the tissues are stretched to accommodate more fat, and it has been shown that maximum final increase in size is up to 300cc or more.

The Bougainvillea Clinique is one of a select group of plastic surgery practices that participate in a nationwide study protocol using BRAVA® and fat grafting for breast augmentation and reconstruction.

Tissue Expansion for Breast Surgery

BRAVA® is an external tissue expansion device that expands breast tissue in preparation for fat grafting.  Tissue expansion is especially important for breast reconstruction cases, in which a significant amount of tissue is removed in mastectomy. Before the BRAVA®, the only way to expand the tissue for breast reconstruction was with an adjustable saline breast implant – the volume of the implant is increased in stages, expanding tissue over time. BRAVA® provides an external means of tissue expansion, without the use of a breast implant. External expansion with BRAVA® is very different to internal expanders used in other reconstruction techniques. Whereas with BRAVA® the tissues are expanded like a sponge to allow more fat to be grafted and survive, internal expanders creat a space under the skin to accommodate a breast implant and actually stretch and thin the skin in the process. Internal expanders are associated with a high rate of complications, particularly in radiated patients. BRAVA® on the other hand has been shown to actually improve the quality of the underlying tissues.

Combining BRAVA® with fat grafting is a true tissue regenerative process. Breasts reconstructed with this procedure is the closest we have yet come to truly regenerating a breast in the mastectomy patient.

The Breast Center at the Bougainvillea Clinique is presently one of only 5 co-investigator study sites in the US participating in a study titled ' Breast Reconstruction and Augmentation with Brava enhanced Autologous Fat Micrografting'.

Advantages of BRAVA®

The survival of fat is a primary concern in a fat grafting procedure. Some percentage of fat always dies, but tissue expansion promotes the survival of greater percentages of fat.

When fat is grafted to your breast, survivability of the fat is affected by a decreased blood supply, which is brought about by blood vessels that are constricted by the pressure of the newly injected fat. By expanding the tissue before the fat is injected, circulation to the tissue is increased, creating an environment in which the fat can better survive.

Tissue expansion also makes room to accommodate the fat graft, providing the possibility of a larger augmentation.

How big can you go with BRAVA® and Fat Grafting

Generally the amount of fat that can be injected at any one time is dependent on the amount of expansion achieved with BRAVA®, and we use the two-thirds rule. The rule states that your final breast size will be about two-thirds of the size you achieve with BRAVA® expansion. This means that if you want to double your breast size, you have to triple the breast size with BRAVA® before the grafting. The success of the grafting procedure and the amount of fat retained is directly proportional to your commitment to wearing the BRAVA®. The more you expand the breasts before the grafting procedure, the larger the final result will be.

The more committed the patient is to using the BRAVA®, the better the results with fat grafting.

* Disclaimer The BRAVA® device is presently FDA approved for breast enlargement without fat grafting, and is presently being studied under an FDA sanctioned study for combined expansion and fat grafting (BRAVA® + AFT) for breast reconstruction and augmentation. A recent published study has demonstrated the safety and efficacy of the BRAVA® expansion with fat grafting process, as well as a significantly higher final fat graft volume and survival. With almost 1000 cases of documented BRAVA® combined with fat grafting, this procedure has been found to to be overwhelmingly safe, and arguably much safer with far fewer complications than other options for breast reconstruction.

You can find more informationon on the BRAVA® and how it is used on our FAQ page.

To learn more about the BRAVA® device and breast reconstruction for women living in Winter Park, Orlando or the surrounding Florida cities, please contact plastic surgeon Dr. Jeffrey Hartog to schedule a consultation.

4355 Bear Gully Road
Winter Park, FL 32792